BACKGROUND: Laser resurfacing of cutaneous scars, rhytides, and photodamaged skin has become very popular. Pulsed erbium:YAG laser resurfacing has recently come into favor for the treatment of pitted acne scars. OBJECTIVE: This study was designed to investigate the efficacy and safety of pulsed erbium:YAG laser in cutaneous resurfacing of pitted acne scars. METHODS: 100 patients with pitted acne scars were enrolled in this study. All patients were treated by means of a pulsed erbium:YAG laser with a 2 mm handpiece at the setting of 500 to 1000mJ/pulse and fluences used varied between 5-15J/cm2. Photographs of the face were obtained at baseline and 2 week postoperatively. Two weeks after treatment, postoperative care such as applying hydroquinone 4% and tretinoin 0.05% was recommended for 2 to 4 weeks. RESULTS: Out of 100 patients, 20% of patients showed an excellent response, 50% a good response, 21% a fair response and 9% a poor response. After 6 months, erythema had developed in two patients and and three patients had developed postinflammatory hyperpigmentation, hypopigmentation and delayed contact dermatitis. CONCLUSION: Treatment with pulsed erbium:YAG laser shows high efficacy and low morbidity in pitted acne scar resurfacing.
Acne Vulgaris* ; Cicatrix* ; Dermatitis, Contact ; Erythema ; Humans ; Hyperpigmentation ; Hypopigmentation ; Postoperative Care ; Skin ; Tretinoin

PURPOSE: The purpose of this study was to investigate factors associated with suspicious developmental delay in infants and early childhood. METHODS: Participants were 133 infants, aged from birth to 6 years old and their mothers, who were being seen at 16 Public health centers in B city. Korean Denver II was used to test infant development. chi2-test, Fisher's exact test and multiple logistic regression were used with SPSS 19.0 to analyze data. RESULTS: Of participant infants, 7.5% were below the 3rd percentile for the weight percentile, 8.4% is a weight curve that crosses more than 2 percentile lines on the growth charts after previous achievement, and 9.8% had suspicious developmental delay according to Korean Denver II. Further the predictive factors related to suspicious development delay in the children were decrease of weight percentile (Odds Ratio [OR]=6.69, Confidence Interval [CI])=1.22-36.45), low economic state (OR=6.26, CI=1.50-26.00), and developmental delay perceived by their mothers (OR=4.99, CI=1.24-20.06). CONCLUSION: It is necessary to build a government level system to follow management of development of infants and children from the time of birth. Especially, it is necessary to develop a program for children in low income families.
Achievement ; Aged ; Child ; Child Development ; Growth Charts ; Humans ; Infant ; Logistic Models ; Mothers ; Parturition ; Public Health

Syndromal acanthosis nigricans is associated with cellular resistance to the action of insulin and other endocrinopathies. In the insulin resistant state, increased insulin binds to the receptors of insulin-like growth factors (IGFs). IGFs are growth prompting peptides, which act as direct mitogens on cells containing the receptors. Through these actions, increased cellular growth and metabolism cause the skin lesions of acanthosis nigricans. Hyperandrogenism is also found in syndromal acanthosis nigricans patients. When associated with insulin resistance, these states are proportionally related. Increased insulin prompts the synthesis of androgen and conversely, increased androgen elevates the insulin resistance. We present three cases of syndromal acanthosis nigricans with hyperpigmented skin lesions and obesity. Laboratory findings demonstrated normal fasting blood suga levels with increased insulin and C-peptide levels and decreased insulin receptors. The oral glucose tolerance test was normal. We suggest that these patients were in an insulin resistant state. Skin biopsies from the axilla in all three cases showed hyperkeratosis, irregular acanthosis and upward projection of dermal papillae as finger like fashion. Thus all three cases represent syndromal acanthosis nigricans associated with an insulin resistant state based on clinical, histopathological, and laboratory findings. The three patients were treated with dietary control.
Acanthosis Nigricans* ; Axilla ; Biopsy ; C-Peptide ; Fasting ; Fingers ; Glucose Tolerance Test ; Humans ; Hyperandrogenism ; Insulin Resistance* ; Insulin* ; Metabolism ; Mitogens ; Obesity ; Peptides ; Receptor, Insulin ; Skin ; Somatomedins

Trichoblastoma is a rare benign neoplasm that arises in the follicular germinative cells. The terminology and histopathological definition of this tumor is both complex and confusing. Trichoblastoma occurs only on the hair bearing areas such as the scalp, face and pelvic area with varying degrees in size. We describe a case of trichoblastoma occurring as a nodule on the nose. The tumor was composed of numerous lobules of basaloid epithelial cell nests with distinct peripheral palisading of nucleoli that were clearly demarcated from the stroma.
Epithelial Cells ; Hair ; Nose ; Scalp

No abstract available.
Cicatrix* ; Herpes Zoster* ; Histiocytoma, Benign Fibrous*

No abstract available.
Child* ; Hair* ; Humans

OBJECTIVE: The purpose of this study is to investigate the prognostic factors and appropriate treatment in patients with intracerebral hemorrhage secondary to ruptured middle cerebral artery(MCA) aneurysms. METHODS: Among 120 cases with ruptured MCA aneurysms during last 9 years from 1993 to 2002, 85 cases was analyzed according to hematoma distribution. All cases were included in one of three groups Group A(15 cases) having an intraparenchymal hematoma(IPH) larger than 5cc with or without subarachnoid hemorrhage(SAH). Group B(25 cases) having an intrasylvian hematoma(ISH) with or without SAH. Group C(45 cases) having a diffuse SAH without localized hematoma. Prognosis was evaluated postoperatively by applying Glasgow Outcome Scale(GOS) at discharge. RESULTS: In Group A, hypertension and Hunt-Hess(H-H) grade on admission, hematoma volume larger than 15cc and postoperative edema were corrleated with poor outcome. In Group B, old age, postoperative edema and delayed ischemic neurologic deficit(DIND) were related to poor outcome. Group C revealed better consciousness on admission and favourable outcome than Group A and B. CONCLUSION: We suggest that therapeutic consideration in Group A is focused on postoperative edema after early surgical intervention and in Group B is focused on postoperative edema with DIND after removal of residual clot in sylvian fisssure as much as possible by irrigation and suction.
Aneurysm ; Cerebral Hemorrhage* ; Consciousness ; Edema ; Hematoma ; Hemorrhage* ; Humans ; Hypertension ; Intracranial Aneurysm* ; Middle Cerebral Artery* ; Prognosis ; Suction

Heterotopic gastric mucosa in the upper esophagus is frequently found during endoscopic examination. Although most patients with heterotopic gastric mucosa of the upper esophagus, referred as inlet patch, are asymptomatic, symptomatic patients with complications resulting from this ectopic mucosa have also been reported. Acid secretion by the inlet patch has been suggested in some reports. We report a case of heterotopic gastric mucosa in the upper esophagus, with secretion of acid, demonstrated by continuous ambulatory pH monitoring, and the improvement of pharyngeal symptoms after the use of a proton pump inhibitor.
Adult ; Ambulatory Care ; Anti-Ulcer Agents/administration & dosage ; Case Report ; Choristoma/diagnosis* ; Esophageal Diseases/drug therapy ; Esophageal Diseases/diagnosis* ; Esophagoscopy ; Gastric Acid/secretion* ; Gastric Mucosa/secretion* ; Human ; Hydrogen-Ion Concentration ; Male ; Monitoring, Physiologic/methods ; Prognosis

In order to evaluate the possible roles of secretory proteases in the pathogenesis of amoebic keratitis, we purified and characterized a serine protease secreted by Acanthamoeba lugdunensis KA/E2, isolated from a Korean keratitis patient. The ammonium sulfate-precipitated culture supernatant of the isolate was purified by sequential chromatography on CM-Sepharose, Sephacryl S-200, and mono Q-anion exchange column. The purified 33 kDa protease had a pH optimum of 8.5 and a temperature optimum of 55 degrees C. Phenylmethylsulfonylfluoride and 4- (2- Aminoethyl) -benzenesulfonyl-fluoride, both serine protease specific inhibitors, inhibited almost completely the activity of the 33 kDa protease whereas other classes of inhibitors did not affect its activity. The 33 kDa enzyme degraded various extracellular matrix proteins and serum proteins. Our results strongly suggest that the 33 kDa serine protease secreted from this keratopathogenic Acanthamoeba play important roles in the pathogenesis of amoebic keratitis, such as in corneal tissue invasion, immune evasion and nutrient uptake.
Acanthamoeba/*enzymology/isolation & purification/pathogenicity ; Acanthamoeba Keratitis/*parasitology ; Animals ; Cornea/parasitology ; Humans ; Hydrogen-Ion Concentration ; Korea ; Serine Endopeptidases/chemistry/*isolation & purification/*metabolism ; Substrate Specificity ; Temperature ; Virulence Factors

We describe the case of a 45-year-old woman who had self-regressing livedo reticularis on the lower extremities. Examination of a biopsy specimen from the mottled area revealed myxomatous emboli in the deep dermal arterioles. Echocardiography showed a myxoma in the left atrium. After the tumor was surgically excised, the patient had no further evidence of the disorders during the 3-year period of follow-up. Livedo reticularis caused by an peripheral arterial embolism, which in turn was caused by the tumor fragments in our patient with left atrial myxoma, is considered to be unusual.
Arterioles ; Biopsy ; Echocardiography ; Embolism ; Female ; Follow-Up Studies ; Heart Atria ; Humans ; Livedo Reticularis* ; Lower Extremity ; Middle Aged ; Myxoma*